Remote Physician ED Claims Reviewer (UM & Coding)
Vytwo
- Remote job
Vytwo seeks a Physician ED Claims Reviewer for a 12-month remote assignment. The clinician will conduct clinical review of claims and UM authorization requests to determine clinical necessity, leveraging CPT/HCPCS coding and managed care expertise. Ideal candidates hold an active US medical license with 3–5 years of emergency department medicine experience or equivalent internal medicine background, and possess strong knowledge of claims processing and medical coding. #J-18808-Ljbffr Vytwo
- ...Role: Physician ED Claims Reviewer Duration: 12 months Required skills: Physician... ...experience in with medical coding (CPT/HCPCS) and managed care... ...clinical review of claims and UM authorization requests for clinical... ...in a fast paced environment. This is a remote position....Remote workClaims
- ...experienced DRG Clinical Physician Reviewer to join our growing... ...team. This is a fully remote opportunity for a... ...improved documentation, coding accuracy, and cost containment... ...review experience (UM, DRG Validation, or... ...Validation, CDI, or claims review strongly preferred...Remote workClaims
- ...are currently looking for a Physician Reviewer to join our growing team on a... ...reviewer role at tango - providing UM case reviews, peer to peer... ...support. Office Location Remote - flexible hours Essential Functions... ..., and retroactive and claims reviews of medical home health...Remote jobClaimsFull timeWork at officeLocal areaWork from homeFlexible hours
- ...Job Description Job Description Physician Peer Reviewer – Multiple Specialties in Texas and/or New... ...MEXICO to assist with independent review claims and appeals in any of the following... ...past 3 years, if performing external reviews Job Type Contract Work Location Remote...Remote workClaimsContract workWork experience placementWork at office
- ...Medical Director for review. Refer to and work closely... ...with the treating physician or other providers of... ...for pricing, coding, researching claims to ensure accurate application... ...multiple areas (i.e. UM and CM). Incumbent is... ...be opportunity for remote work within all jobs...Remote workClaimsContract workWork at office
- A recognized healthcare provider is seeking a Board Certified Orthopaedic Spine Surgeon to conduct utilization reviews. This telework position allows for a flexible schedule within a standard Monday - Friday work week. Responsibilities include reviewing medical records,...Remote jobClaimsFor contractorsMonday to FridayFlexible hours
$85k - $90k
...DRG Reviewer At MedReview, our mission is to bring accuracy... ...conducts reviews of inpatient claims to ensure coding accuracy and appropriate... ...diagnoses. This is a fully remote position. Candidates must be... ...guides. Collaborates with physician reviewers, as needed....Remote workClaims- ...Claims Reviewer Location: Phoenix AZ 85053 (REMOTE) Duration: 6+ Months Pay Range: $28.00/hr on W2 Shift: Mon Fri 8.00 AM 5 PM PST Job Summary... ...resolution, audit, and related functions. Applies clinical, coding, and processing knowledge to conduct review of...Remote workClaimsContract workFor subcontractorInterim roleShift work
- ...expertise as a Certified Physician Coder will make a... ...care through accurate coding practices. You will play... ...responsibility will be to review and analyze medical documentation... ...become eligible for remote work, providing... ...necessary for effective claims processing. Experience...Remote workClaimsFull timeMonday to FridayFlexible hours
- ...looking for a dedicated Coding Improvement Coordinator to join the Physician Billing team. Full-time... ...general office hours, working remotely. This position is... ...for the development of claim edits, warnings, and hard... ...level coding validation reviews. Provides training and information...Remote workClaimsPermanent employmentFull timeWork at officeMonday to FridayFlexible hoursDay shift
$50 - $65 per hour
...Priority Areas Medical coding, including inpatient,... ...portals, utilization review, and utilization management... ...Relevant Experience Claims, billing, and end-to-... ...come from hospitals, physician groups and ambulatory practices... .... Work Terms Remote, hourly engagement....Remote workClaimsHourly payWork at office10 hours per week- ...will be doing in this role:The Physician Compliance Auditor is responsible for reviewing and auditing claims, medical records, and charges... ...applicable documentation, coding, and billing requirements. Works... ...the use of Teams or other remote meeting platforms. The Physician...Remote jobClaims
- ...Neurosurgeon, Neurologist, and Physical Medicine & Rehabilitation physician to process utilization reviews. Work's Compensation experience is preferred but not... ...clinical expertise, and reviews workers' compensation claims by providing an interpretation of the medical...Remote workClaimsFor contractorsMonday to Friday
- ...Oak Street Health is seeking a Full-Time Utilization Management Physician Reviewer to provide accurate coverage determinations for inpatient and outpatient services, applying UM criteria, clinical judgment, and internal policies. You will coordinate with care teams to...Remote workFull time
$204.76k - $292.52k
...Physician Reviewer We're unique. You should be, too. We're changing lives every day. For both our patients and our team members. Are you... ...is the primary physician reviewer for Utilization Management (UM) cases in our organization. Other duties include advising other...Remote workHourly payFull timeWork at officeLocal area$125k - $210k
...Impact Advisors is seeking an experienced Physician Enterprise Healthcare Consultant with... ...-service collections, charge capture, coding, claims submission, payment posting, denial management... .... Work Schedule Full‑time, exempt, and remote‑friendly when not traveling, with...Remote workClaimsFull time- ...looking for a skilled individual to manage dental claims processing. Responsibilities include preparing... ...strong knowledge of dental billing, including coding (ICD-10, CPT) and have effective communication skills. This remote position requires excellent attention to detail...Remote workClaims
- ...Remote Hialeah, FL Miami, FL Full time R... ...staff position, please review this tip sheet ( . The... ...key resource for CDI/Coding/Quality. The CDI Second... ...measuring and reporting physician and hospital outcomes.2... ...welcome.miami.edu/about-um to learn more about our...Remote workFull timeTemporary workWork at officeWorldwide
$3,000 - $4,999 per month
...Functional Title: PASRR Specialized Services Reviewer Job Title: Program Specialist IV Agency:... ...701 W 51ST ST Other Locations: None MOS Codes: 16GX,60C0,611X,612X,63G0,641X,712X,86M0,... ...services authorization and related claims or payment issues. The position identifies...Remote workClaimsFull timeTemporary workPart timeWork at officeShift workDay shift$240k
...Utilization Management Physician (UMP) Remote | Full-Time | Florida Compensation... ...perform medical necessity reviews, peer-to-peer discussions,... ...-auths, concurrent reviews, claims, and appeals Make medical... ...to-peer reviews and support UM staff Participate in committees...Remote workClaimsFull timeRelocation- ChenMed LLC seeks a physician with strong clinical and UM background to cover delegated utilization management across multiple territories. The role requires... ..., and 2+ years in hospital medicine, with utilization review experience preferred. You will coordinate with PCP/SNF...Remote job
- ...services designed to manage the total cost of care. We are currently looking for a Physician Reviewer to join our growing team on a full time basis. The Physician Reviewer provides real-time UM case reviews, peer-to-peer discussions and education across utilization...Remote jobFull time
- ...training one day, then remote for full assignment... ...between Members, Physicians, Delegates,... ...Responsibilities: - Performs review of service requests... ...medical/claim policy related issues... ...for conducting any UM review activities that... ..., billing & claims coding/processing - Prefer...Remote workClaimsWork experience placement
- A leading independent review organization is seeking a Utilization Management Physician Reviewer for a full-time remote role. Candidates must possess an active Nebraska medical license... ...Friday with occasional weekend work required. #J-18808-Ljbffr ExamWorks UM StrategiesRemote jobFull timeCasual workMonday to Friday
$175k - $185k
...for Utilization Management (UM) and Utilization Review (UR) programs. This role... ...appropriate adjudication of dental claims and prospective service... ...in dental procedure coding, claims adjudication, and medical... ...educational expenses.Remote or hybrid work options available...Remote jobClaimsWork at officeImmediate startRelocationVisa sponsorshipFlexible hours- ...This need will be FULLY remote while the provider is... ...Responsibilities: ~ Reviews prior authorization and... ...approval or denial of claims payment based on... ...define acceptability of physician performance, conducts review... ...Participation in a managed care UM committee - PREFERRED...Remote workClaimsPermanent employmentLocumLocal areaWeekend work
- ...Dane Street, LLC is seeking Board Certified Physicians to join our Disability Peer Review team. This telework opportunity allows physicians to evaluate disability claims remotely, offering complete flexibility in scheduling and the ability to dictate workload based on...Remote workClaimsWork from home
- ...Billing Compliance Auditor & Physician Educator with a minimum of three... ...and facility billing claims. This position will primarily... ...in Tewksbury, MA, with some remote work flexibility. Key Responsibilities... ...accuracy, compliance with coding guidelines, and regulatory...Remote workClaims
$248.5k - $373k
...ll enjoy the flexibility to work remotely * from anywhere within the U.S.... ...care management, clinical coverage review, member appeals clinical review, medical claim review and provider appeals... ...or DO degreeActive, unrestricted physician state licenseCurrent board certification...Remote workClaimsMinimum wageFull timeWork experience placementWork at officeLocal area- ...Dane Street, LLC is seeking Board Certified Physicians for a remote Disability Peer Review team. This role allows for evaluating and reviewing disability claims from home, providing flexible scheduling to balance work and lifestyle. Applicants must have a current medical...Remote workClaimsFlexible hours
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